EX-10.2 3 fa905.htm FA905 - AMENDMENT 10 fa905.htm
                    
 
HealthEase of Florida, Inc.
Exhibit 10.2
 
 Medicaid HMO Non-Reform Contract


AHCA CONTRACT NO. FA905
AMENDMENT NO. 10
 
THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" and HEALTHEASE OF FLORIDA, INC., hereinafter referred to as the "Vendor" or “Health Plan”, is hereby amended as follows:
 
  1.
Effective May 1, 2012, Attachment I, Scope of Services, Capitated Health Plans, is hereby amended to include Attachment I, Exhibit 1-D, Revised Maximum Enrollment Levels, attached hereto and made a part of the Contract. All references in the Contract to Attachment I, Exhibits 1, 1-A, 1-B, and 1-C, shall hereinafter also refer to Attachment I, Exhibit 1-D, as appropriate.
 
Unless otherwise stated, this amendment is effective upon execution by both Parties.
 
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the Contract.
 
This amendment and all its attachments are hereby made a part of the Contract.
 
This amendment cannot be executed unless all previous amendments to this Contract have been fully executed.
 
IN WITNESS WHEREOF, the Parties hereto have caused this five (5) page amendment (including all attachments) to be executed by their officials thereunto duly authorized.
 
 
 
WELLCARE OF FLORIDA, INC., D/B/A
STATE OF FLORIDA, AGENCY FOR
STAYWELL HEALTH PLAN OF FLORIDA
 
HEALTH CARE ADMINISTRATION
SIGNED
BY:
 /s/Christina Cooper
SIGNED
BY:
 /s/Elizabeth Dudek
NAME:
Christina Cooper
NAME:
Elizabeth Dudek
TITLE:
President, Florida and Hawaii Division
TITLE:
Secretary
DATE:
   5/7/12
DATE:
 5/9/2012

List of Attachments/Exhibits included as part of this amendment:
 
Specify
Letter/
 
Type
Number
Description
  
Attachment
Exhibit 1-D
Revised Maximum Enrollment Levels (4 Pages)
 
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AHCA Contract No. FA905, Amendment No. 10, Page 1 of 1

 
 
 
 
 HealthEase of Florida, Inc.  Medicaid HMO Non-Reform Contract



ATTACHMENT I
EXHIBIT 1-D
REVISED MAXIMUM ENROLLMENT LEVELS
 
Maximum enrollment levels and Health Plan provider numbers associated with the counties and populations served. Exhibit 2-NR-C provide the capitation rate tables respective to the areas of operation listed below.
 
A. Non-Reform
 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 1 Counties: Escambia, Santa Rosa
Effective Dates: 11/01/11 Escambia, 08/01/11 Santa Rosa
County
Enrollment Level
Provider Number
Escambia
67,500
015019344
Santa Rosa
31,500
015019343

 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 2 Counties: Bay, Calhoun, Gadsden, Jefferson, Leon, Liberty, Madison, Wakulla
Effective Dates: 03/01/12 Bay, 09/01/09 all other counties
County
Enrollment Level
Provider Number
Bay
16,900
015019345
Calhoun
800
015019340
Gadsden
3,500
015019315
Jefferson
1,000
015019318
Leon
7,000
015019320
Liberty
400
015019342
Madison
1,500
015019322
Wakulla
1,000
015019336
 
 
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AHCA Contract No. FA905, Attachment I, Exhibit 1-D, Page 1 of 4
 
 
 
 HealthEase of Florida, Inc.  Medicaid HMO Non-Reform Contract

See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 3 Counties: Citrus, Lake, Marion, Putnam
Effective Date: 09/01/09
County
Enrollment Level
Provider Number
Citrus
7,500
015019309
Lake
7,000
015019319
Marion
20,000
015019323
Putnam
6,000
015019329

 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 4 Counties: Duval, Volusia, St. Johns
Effective Dates: 05/01/12 St. Johns, 09/01/09 Duval and Volusia
County
Enrollment Level
Provider Number
Duval
55,000
015019313
Volusia
15,000
015019335
St. Johns
8,300
TBD

 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 5 Counties: Pasco, Pinellas
Effective Date: 09/01/09
County
Enrollment Level
Provider Number
Pasco
6,000
015019302
Pinellas
9,000
015019303
 
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AHCA Contract No. FA905, Attachment I, Exhibit 1-D, Page 2 of 4
 
 
 
 HealthEase of Florida, Inc.  Medicaid HMO Non-Reform Contract

See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 6 Counties: Highlands, Hillsborough, Manatee, Polk, Hardee
Effective Dates: 05/01/12 Hardee, 09/01/09 all other counties
County
Enrollment Level
Provider Number
Highlands
3,000
015019317
Hillsborough
18,000
015019300
Manatee
6,000
015019301
Polk
10,000
015019304
Hardee
4,100
TBD

 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 7 Counties: Brevard, Orange, Osceola, Seminole
Effective Date: 09/01/09
County
Enrollment Level
Provider Number
Brevard
14,000
015019308
Orange
25,000
015019327
Osceola
8,000
015019328
Seminole
4,000
015019333

 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 8 County: Sarasota
Effective Date: 09/01/09
County
Enrollment Level
Provider Number
Sarasota
3,000
015019332
 
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AHCA Contract No. FA905, Attachment I, Exhibit 1-D, Page 3 of 4
 
 
 
 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 9 Counties: Martin, Palm Beach
Effective Date: 09/01/09
County
Enrollment Level
Provider Number
Martin
5,000
015019324
Palm Beach
10,500
015019339

 
See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 10 County: Broward
Effective Date: 09/01/09
County
Enrollment Level
Provider Number
Broward
13,500
015019337

See Exhibit 2-NR-C Table 2, General Capitation Rates plus Mental Health Rates
 
Area 11 County: Miami-Dade
Effective Date: 09/01/09
County
Enrollment Level
Provider Number
Miami-Dade
25,000
015019338
 
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AHCA Contract No. FA905, Attachment I, Exhibit 1-D, Page 4 of 4